Nishiyama T, Yokoyama T, Hanaoka K
Department of Anesthesiology, University of Tokyo.
Can J Anaesth. 1998 Aug;45(8):789-93. doi: 10.1007/BF03012151.
To compare retrospectively liver and renal function after repeated exposure (twice) to sevoflurane or isoflurane.
Sixty patients were studied for liver and renal function after repeated exposure within 30 to 180 days to sevoflurane (30 patients) or isoflurane (30 patients). Serum concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GTP), blood urea nitrogen (BUN) and creatinine (Cr) were measured before and, 1, 3, 7, and 14 days after surgery. Qualitative analyses of urinary protein and glucose were done 1, 3, and 7 days after surgery.
The number of patients with abnormal values in AST, ALT and GTP was larger in the isoflurane than in the sevoflurane group. BUN and Cr were within normal range after anaesthesia in either group. Renal excretion of protein and glucose increased one and three days after anaesthesia with no difference between the anaesthetics. None of the variables showed differences between the first and second anaesthesia after either anaesthetic.
Repeat exposure to sevoflurane or isoflurane within 30 to 180 days had no additional risk of increasing serum concentration of liver enzymes or increasing urinary excretion of protein and glucose compared with the first exposure to the same anaesthetic.
回顾性比较七氟醚或异氟醚重复暴露(两次)后的肝肾功能。
对60例患者进行研究,这些患者在30至180天内重复暴露于七氟醚(30例)或异氟醚(30例)后接受肝肾功能检查。在手术前以及手术后1、3、7和14天测量血清天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBil)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GTP)、血尿素氮(BUN)和肌酐(Cr)的浓度。在手术后1、3和7天对尿蛋白和葡萄糖进行定性分析。
异氟醚组中AST、ALT和GTP值异常的患者数量多于七氟醚组。两组麻醉后BUN和Cr均在正常范围内。麻醉后1天和3天肾对蛋白质和葡萄糖的排泄增加,两种麻醉剂之间无差异。两种麻醉剂首次和第二次麻醉后,各项变量均无差异。
与首次暴露于相同麻醉剂相比,在30至180天内重复暴露于七氟醚或异氟醚不会增加血清肝酶浓度或增加尿中蛋白质和葡萄糖排泄的额外风险。